• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.3
• /
• pp.217-220
• /
• 2010

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative lesion on oral mucosa featuring as a benign mass of self-limiting growth. It can be easily misdiagnosed as squamous cell carcinoma (SCC) due to its long healing period and elevated or rolled-up margin. A 57-year old male patient who visited our department was diagnosed as SCC according to the clinical features, results of positron emission tomography (PET) and magnetic resonance imaging (MRI) of the oral lesion. However, after performing incisional biopsy, histopathologically, there were no atypical cells, but eosinophil and CD 30+ T-cells were clustered in subcutaneous and muscle tissue. It is very significant to consider this reactive lesion in the field of oral and maxillofacial surgery because of its possibility of mistaken as malignant disease. Here, we will report a couple of cases of TUGSE with references and limit of radiographic tools used for diagnosis of head and neck cancer.

• Radiation Oncology Journal
• /
• v.11 no.2
• /
• pp.267-275
• /
• 1993

Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery. And 70 patients received external irradiation only by $^{60}Co$ with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III+IV were 57 patients. Acturial overall survival rate at 3 years was $43.9\%,$ 3 year survival rates were $60.9\%$ for stage I + II, and $23.1\%$ for stage III+IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3+T4 or in any N stage although it was not statistically sufficient (p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially In the view of pertainig of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.4
• /
• pp.324-331
• /
• 2010

The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.38 no.3
• /
• pp.284-289
• /
• 2011

Lesch-Nyhan syndrome is a disease caused by metabolic disorder of purine. General muscle stiffness and hyposomia are shown from infancy and symptoms can include involuntary or irregular movements of arms and legs, mental retardation, and compulsive self-mutilating behaviors. Self-mutilating behaviors begin at approximately the first year or sometimes at late teens. The patients bite their lips, especially lower lip, tongue, buccal mucosa, hands and fingers. Tongue and lips can be injured or mutilated in severe cases. As the patient gets older, self-mutilating behaviors become more serious and extensive and secondary infection of injured areas is possible. Periodic soft tissue damage due to self-mutilating may evolve to cancer. Medical treatment, appliance treatment, extraction of tooth and surgical operation was attempted to control self-mutilaing behaviors. We hereby report the case of child Lesch-Nyhan syndrome patient who has self-inflicted labial damage as chief complaint. When patient was treated with conservate therapy, such as removable or fixed appliance, the frequency of labial damage could be subdued and yielded favorable results.